Therapist Memory for Treatment Contents: Implications for Patient Outcomes

TL;DR

This study finds that therapists who better remember treatment details help patients with depression improve more quickly and maintain progress.

Contribution

The study is the first to demonstrate a direct link between therapist memory accuracy and patient outcomes in depression treatment.

Findings

Better therapist cumulative recall significantly reduced patient depression severity from pre- to post-treatment.

Therapist memory of past sessions improved patient functional impairment across treatment conditions.

Cumulative recall had a stronger effect on depression outcomes than past session recall.

Abstract

This secondary analysis evaluates the impact of therapist memory on patient outcomes in the context of a randomized trial comparing cognitive therapy plus memory support (CT+Memory Support) to cognitive therapy as usual (CT−as−usual).

Participants were 172 adults (mean age [SD] = 37.46 [15.31]; 62.79% female; 59.88% Caucasian) with major depressive disorder. Patients were treated by 19 therapists (age mean [SD] = 28.4 [5.95] years; 78.95% female; 42.11% Caucasian), with each therapist treating an average of 9 patients. Therapists completed cumulative and past session recall assessments immediately following sessions during weeks 4, 8, and 12, and the final session. Patient depression symptom severity (Inventory for Depressive Symptomatology Self−Report) and functional impairment (World Health Organization Disability Assessment Schedule 2.0) were self−reported at pre−treatment, post−treatment, 6−month (6FU), and 12−month follow−ups (12FU).

Multilevel modeling revealed that better therapist cumulative recall predicted lower depression severity from pre− to post−treatment (unstandardized b = −3.43, p < 0.001) and at 6FU (b = −2.72, p < 0.001). Therapist cumulative recall predicted improved patient functional impairment in CT−as−usual only (b = 3.11, p = 0.02). Therapist past session recall (b = −2.68, p = 0.01) predicted improved functional impairment across treatment conditions. All other comparisons were non−significant, but the majority were in the hypothesized direction.

These results signal a relationship between therapist memory and patient outcomes. Future research is needed to verify these findings and investigate ways to optimize therapist memory for treatment.

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